CEPOP Policy Roundtable on Expanding Naloxone Access

CEPOP will host a virtual Policy Roundtable on Expanding Naloxone Access Wednesday, March 31st at 1:00pm ET. We’re pleased to be joined by thought leaders across the agency, public health, provider, and employer landscape. The Roundtable will address prescribing opportunities, improving community-based access, and developing a path from naloxone use to treatment and recovery.

CEPOP Policy Roundtable on Expanding Naloxone Access

Bipartisan Lawmakers Introduce CARA 3.0 to Increase Funding for Evidence-Based Addiction and Recovery Programs

Last week, Senators Rob Portman (R-OH), Sheldon Whitehouse (D-RI), Shelley Moore Capito (R-WV), Amy Klobuchar (D-MN), and Jeanne Shaheen (D-NH) introduced the Comprehensive Addiction and Recovery Act (CARA) 3.0, which would increase funding authorization levels for original CARA and CARA 2.0 evidence-based prevention, treatment, recovery, and criminal justice programs. CARA 3.0 includes many new policy changes, including conducting new research on non-opioid alternatives and long-term treatment outcomes, prohibiting states from requiring prior authorization for medication assisted treatment (MAT) under Medicaid, removing the limit on the number patients a physician can treat with buprenorphine and methadone, permanently allowing providers to prescribe MAT without a prior in-person visit and to bill Medicare for audio-only telehealth services, expanding recovery housing, establishing a pilot program for rural and underserved areas to examine the use of mobile methadone clinics, establishing a National Commission for Excellence in Post-Overdose Response, and requiring programs to deliver more culturally competent services.

The original CARA became law in 2016, and several key provisions were included in CARA 2.0 as part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act enacted in 2018. In a press release, Senator Portman said, “in recent years we have made progress in fighting the scourge of addiction thanks to resources from the bipartisan CARA law, in addition to other bipartisan efforts in Congress. However, the COVID-19 pandemic has created unprecedented challenges and we are now seeing another heartbreaking surge in overdose deaths. That is why we must redouble our efforts to combat addiction and help those who are suffering during this crisis. In the new Congress, we have a unique opportunity to work together in a bipartisan way and I believe that CARA 3.0 can help us make a real difference in combating this epidemic.”

Articles & Resources

Representative Rob Portman – Portman, Whitehouse, Capito, Klobuchar, Shaheen Introduce CARA 3.0 to Increase Access to Treatment, Prevention & Bolster Fight Against Addiction Epidemic

CARA 3.0 Bill Text

CARA 3.0 Section by Section

CARA 3.0 Summary

Measure Reintroduced to Provide Investments Towards Substance Use Disorder Response

Last week, Senators Jeanne Shaheen (D-NH) and Maggie Hassan (D-NH) reintroduced the Turn the Tide Act, which would invest $63 billion over 10 years in substance use disorder (SUD) prevention programs and efforts addressing treatment workforce challenges. This version of the bill also includes a new provision which would allow Medicaid to cover the costs of recovery housing through a five-year Medicaid demonstration model. In a press release, Senator Shaheen said, “this bill comes at a crucial time, investing $63 billion over the next 10 years to bolster our national response to the opioid crisis, with a new provision to invest in recovery housing. I’ll continue to fight in the Senate to invest in substance misuse prevention and treatment to protect our loved ones from this deadly epidemic.” Senator Hassan added, “as we combat the COVID-19 pandemic, we must continue to prioritize addressing the substance use disorder crisis, which remains one of the most persistent public health and safety challenges facing our state. This legislation would provide New Hampshire and other states with sustained investments in treatment and recovery services, while also addressing critical workforce shortages that are hindering efforts to provide the support that Granite Staters struggling with addiction need.” This bill was previously introduced in the House during the 116th Congress.

Articles & Resources

Senator Jeanne Shaheen – Shaheen Reintroduces Bill to Invest $63 Billion to Turn the Tide on the Substance Use Disorder Epidemic

S.2102 – Turn the Tide Act

FDA Develops the Opioid Systems Model for Informing Policy Analysis

The U.S. Food and Drug Administration (FDA) has developed a U.S. population-level system dynamics model of the opioid crisis to identify interventions, assess the consequences of policies, and identify gaps in research. The model reflects the lived experience of opioid use by tracking people through four opioid use states – misuse, use disorder, treatment, and remission – and examining the possible trajectories between those states. According to FDA, the model can be used to project the downstream effects of proposed policies on trajectories and public health outcomes, and will eventually be expanded into an interactive policy tool with policy analysis capabilities. FDA has published a white paper outlining the model and is currently preparing a second publication that documents the model and presents preliminary policy insights.

Articles & Resources

FDA – Opioid Systems Modeling Effort

FDA White Paper on the Opioid Systems Model

One-page Overview on the Opioid Systems Model

Senate Confirms Vivek Murthy as Surgeon General and Rachel Levine as Assistant Secretary for Health

On March 23rd, the United States Senate confirmed Dr. Vivek Murthy for Surgeon General in a 57-43 vote. Dr. Murthy previously served as Surgeon General under former President Barack Obama. During his confirmation hearing, Dr. Murthy emphasized his focus on the opioid epidemic by stating, “we cannot neglect the other public health crises that have been exacerbated by this pandemic, particularly the opioid epidemic, mental illness and racial and geographic health inequities.” On March 24th, the Senate also confirmed former Pennsylvania Secretary of Health Dr. Rachel Levine as Assistant Secretary for Health in a 52-48 vote. During the hearing, Senator Patty Murray (D-WA), highlighted Dr. Levine’s previous commitments to addressing the opioid epidemic in Pennsylvania and stated, “Dr. Levine established herself as a trusted voice to the people of Pennsylvania on matters of public health through her work to establish opioid prescribing guidelines and education for medical students, make lifesaving treatment for opioid overdoses widely available, combat eating disorders, increase health equity, and help the LGBTQ community get health care.”

Articles & Resources

Bloomberg Government – Newly Confirmed Surgeon General to Focus on COVID, Opioids

The New York Times – Rachel Levine, Biden’s pick for health post, is first openly transgender official to be confirmed by Senate

U.S. Senate Committee on Health, Education, Labor, and Pensions – Senator Murray Applauds Confirmation of Dr. Rachel Levine as Assistant Secretary for Health and Dr. Vivek Murthy as Surgeon General

What We Read Last Week

Several articles were published last week pertaining to the opioid epidemic, covering a variety of different components of the issue. Links to relevant articles are provided below.

Articles & Resources

Drug and Alcohol and Dependence – Opioid misuse and family structure: Changes and continuities in the role of marriage and children over two decades

FDA – Remove the Risk Outreach Toolkit

International Journal of Drug Policy – Refusal to carry naloxone among newly-abstinent opioid users and 12-step identity

International Narcotics Control Board – Report of the International Narcotics Control Board for 2020

JAMA – Patient-Reported Opioid Consumption and Pain Intensity After Common Orthopedic and Urologic Surgical Procedures With Use of an Automated Text Messaging System

Journal of the American College of Surgeons – Guidelines for Patient-Centered Opioid Prescribing and Optimal FDA-Compliant Disposal of Excess Pills after Inpatient Operation: Prospective Clinical Trial

Law360 – McKinsey To Pay Nevada $45M To End Opioid Marketing Case

NPR – Judge Blocks Lawsuits Against Sackler Family As OxyContin Bankruptcy Talks Continue

Quartz – Can a new vaccine prevent opioid overdoses?

Representative Davide Trone – Trone Voted Co-Chair of Commission on Combating Synthetic Opioid Trafficking

Reuters – Walgreens wins bid to see California patient Rx data in opioid lawsuit

The Commonwealth Fund – The Spike in Drug Overdose Deaths During the COVID-19 Pandemic and Policy Options to Move Forward

The Hill – Democrats unveil bill to prevent members of the Sackler family from evading lawsuits through bankruptcy

U.S. Attorney’s Office for the District of Massachusetts – Eight Charged with Conspiring to Distribute Fentanyl and Cocaine and Money Laundering Conspiracy

U.S. Attorney’s Office for the District of Massachusetts – Lawrence Man Pleads Guilty to Heroin and Oxycodone Offenses

U.S. Attorney’s Office for the District of New Hampshire – Merrimack Man Sentenced to 24 Months for Fentanyl Trafficking

U.S. Attorney’s Office for the Eastern District of Wisconsin – Federal Judge Sentences “Pill Mill” Co-owner to Prison

UCSF – UCSF and Johns Hopkins University Launch Digital Trove of Opioid Industry Documents

This Week’s Calendar

In the week ahead, there are no relevant events or hearings noticed at this time. In the event that there are any changes to the schedule for this week, we will make additional information available.

Questions about the above content can be directed to sanjyot.sangodkar@faegredrinker.com.